Provider Demographics
NPI:1558013516
Name:VARGAS, ALEXANDRA (MSW)
Entity Type:Individual
Prefix:MISS
First Name:ALEXANDRA
Middle Name:
Last Name:VARGAS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB. VILLA SERENA
Mailing Address - Street 2:CALLE GLADIOLA K13
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612
Mailing Address - Country:US
Mailing Address - Phone:787-516-1402
Mailing Address - Fax:
Practice Address - Street 1:URB. VILLA SERENA
Practice Address - Street 2:CALLE GLADIOLA K13
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-516-1402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-21
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR152471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical